论文部分内容阅读
目的 研究眼肌型重症肌无力 ( OMG)患者的单纤维肌电图 ( SFEMG)及与其他辅助检查的关系 ,期望对临床诊断提供帮助。方法 对 80例 (男 39例 ,女 4 1例 ) OMG患者低频和高频重复神经电刺激 ( RNS)、伸指总肌 (部分额肌 ) SFEMG和血中乙酰胆碱受体抗体 ( ACh RAb)进行测定。结果 伸指总肌 SFEMG示 ,5 0例( 6 2 .5 % )异常 ,表现为颤抖增宽和阻滞。平均颤抖为 ( 4 5 .2± 2 1 .0 )μs,颤抖 >5 5μs所占百分比为 ( 1 8.2± 2 6 .5 ) ,阻滞所占百分比为 ( 8.7± 1 5 .3)。额肌 SFEMG示 ,8例 ( 80 % )异常 ,平均颤抖为 ( 6 6 .3± 2 6 .8)μs,颤抖 >5 5μs所占百分比为 ( 32 .7± 2 8.5 ) ,阻滞所占百分比为 ( 2 8.0± 2 4 .3) ,明显高于正常对照组 ( P<0 .0 0 1 )。 RNS异常率为 2 8.8% ( 2 3/80 )。 ACh RAb滴度增高占 38.8% ( 2 6 /6 7)。 SFEMG的颤抖和阻滞与 RNS递减的程度呈明显的负相关性。 RNS和 ACh RAb异常组平均颤抖明显高于正常组 ( P<0 .0 0 1 )。但 SFEMG正常组仍有 1 3.3% ( 4 /30 ) RNS异常和 2 6 .7% ( 8/30 ) ACh RAb异常。结论 SFEMG在 OMG患者的辅助检查中阳性率最高 ,与 RNS和 ACh RAb具有互补作用 ,三者结合可有助于 OMG的诊断。
Objective To investigate the relationship between single-fiber electromyography (SFEMG) and other auxiliary examinations in patients with ocular myasthenia gravis (OMG), and to provide assistance in clinical diagnosis. Methods RNS, SFEMG and ACh RAb in 80 patients (39 males and 41 females) with OMG underwent repeated low and high frequency electrosurgery (RNS) Determination. Results Extensorial total muscle SFEMG showed 50 cases (62.5%) abnormalities, manifested as increased tremor and block. The average shivering was (45.2 ± 2.1) μs, the percentage of shivering> 55μs was (1.82 ± 2.56), and the percentage of arrest was (8.7 ± 15.3). In frontal muscle SFEMG, 8 patients (80%) showed abnormal mean tremor (66.3 ± 26.8) μs and tremor> 55μs (32.7 ± 2.85) The percentage was (2 8.0 ± 2 4 .3), which was significantly higher than that of the normal control group (P0.01). The abnormal rate of RNS was 2 8.8% (2 3/80). ACh RAb titers increased 38.8% (26/67). There was a significant negative correlation between the tremors and blockings of SFEMG and the degree of decreasing RNS. The average tremor in the RNS and ACh RAb abnormalities group was significantly higher than that in the normal group (P <0. 001). However, there were still 3.3% (4/30) RNS abnormalities and 26.7% (8/30) ACh RAb abnormalities in the normal SFEMG group. Conclusions SFEMG has the highest positive rate in the auxiliary examination of OMG patients, which has the complementary effect with RNS and ACh RAb. The combination of the three can be helpful for the diagnosis of OMG.